Contents

Summary

Major depressive disorder, a common medical disorder with clinically significant morbidity and mortality, is often undiagnosed and undertreated.

Detection of a major depressive episode in the primary care setting often requires a high index of suspicion.

Case-finding (or screening) instruments can be used for early detection, verification of clinical impression, or data collection and documentation.

Optimal treatment of a major depressive episode depends on whether it represents an episode of recurrent major depressive disorder or bipolar disorder, or if it is a consequence of medical illness or substance abuse.

A therapeutic trial of antidepressant medication constitutes a sufficient dosage taken for a sufficient period of time.

Nonpharmacologic antidepressant therapies include brief psychotherapy, exercise, and light therapy; these are effective either alone or in combination with antidepressant medication.